Page 214 - Hospital Authority Convention 2017
P. 214

Service Enhancement Presentations
      HOSPITAL AUTHORITY CONVENTION 2017


             F5.6      Healthcare Advances, Research and Innovations                    09:00  Room 421

            The Analgesic Efficacy of Diclofenac Suppository in Parturients after Caesarean Section
            Ng SW, Ho LF, Leung PH, Ng WYJ
            Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong
            Introduction
            In the past, opioid (Pethidine) injection was used to be the foremost pain relief method for post Caesarean Section. However,
            there are well documented negative side-effects, such as sedation, nausea and vomiting. In order to reduce the opioid
            usage after Caesarean Section, our unit starts to give Diclofenac suppository (NSAID) in May 2016 if there is no medical
            contraindication. It is believed that multi-modal pain therapy, such as combination of NSAID and opioid, could achieve
            the goal of pain relief and minimise the side effects of opioid. Nevertheless, local experience on opioid-sparing effect of
            Diclofenac suppository has not been reported. Therefore, a retrospective study has been conducted.

            Objectives
            To evaluate the analgesic efficacy of diclofenac suppository given to parturients after Caesarean Section.
            Methodology
            This was a retrospective study with all the medical records of parturients undergoing Caesarean Section from March to May
            2016 were reviewed.  Those parturients under general anaesthesia and with post-operative patient controlled analgesia (PCA)
            were excluded from data analysis. This was to circumvent the potential post-anaesthetic effect that would affect opioid
            injection. Analyses were performed by using SPSS (version 16.0) statistical software. Chi-square tests and one-way analysis
            of variance were used to assess the relationship between various variables.
            Results
            Of the 154 subjects in this study, 31.8% (49/154) and 47.4% (73/154) parturients with and without Diclofenac suppository had
            received opioid injection respectively. The group with Diclofenac suppository was less likely to require opioid injection than
            the other group without Diclofenac suppository (p=0.001). For those who needed opioid injection, the mean interval between
            the end of operation and the first opioid injection in Diclofenac group was 7.72±5.55 hours, and in non-Diclofenac group
            was 5.28±4.88 hours (p=0.012). The total dosage of opioid injection given within 24 hours was less in Diclofenac group
            (151.5±65.8mg) than non-Diclofenac group (190.1±98.5mg), and p value = 0.018.
            Results indicated that parturients under regional anesthesia with Diclofenac suppository after Caesarean Section was
            effective in opioid-sparing, and could delay the time of injection and reduce total dosage of opioid requested.






      Wednesday, 17 May



































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